Abstract
PurposeTo evaluate changes in the macula and peripapillary choroidal area at one year after trabeculectomy in order to determine the effect of intraocular pressure (IOP) changes.MethodsThis prospective longitudinal study examined 30 eyes of 30 patients with glaucoma that was uncontrolled by medical therapy. At 1 day before and at 1 year after the trabeculectomy surgery, macular and peripapillary choroidal images were recorded by enhanced depth imaging optical coherence tomography (EDI-OCT). Luminal and interstitial areas were converted to binary images using the Niblack method. Factors influencing the macular choroidal and peripapillary area were examined by multivariate analysis.ResultsAfter trabeculectomy, the mean IOP was 10.8±3.2 mmHg compared to 17.8±7.2 mmHg at baseline (P < 0.001). The total macular choroidal area after the surgery increased from 317,735±77,380 to 338,120±90,700 μm2, while the interstitial area increased from 108,598±24,502 to 119,172±31,495 μm2 (all P < 0.05). The total peripapillary choroidal area after the surgery also increased from 1,557,487±431,798 to 1,650,253±466,672 μm2, while the interstitial area increased from 689,891±149,476 to 751,816±162,457 μm2 (all P < 0.05). However, there were no significant differences observed in the luminal area before and after the surgery. A decrease in the IOP was among the factors associated with the changes in the peripapillary choroidal area.ConclusionsIOP reductions after trabeculectomy led to increases in the macular and peripapillary choroidal areas for at least 1 year postoperative. Increases in the interstitial areas were the primary reason for observed changes in the choroidal area after trabeculectomy.
Highlights
As metabolic support for the prelaminar portion of the optic nerve head is provided by the choroid [1,2,3], this suggests that it may play an important role in glaucoma [4,5,6]
The total peripapillary choroidal area after the surgery increased from 1,557,487±431,798 to 1,650,253±466,672 μm2, while the interstitial area increased from 689,891±149,476 to 751,816±162,457 μm2
A decrease in the intraocular pressure (IOP) was among the factors associated with the changes in the peripapillary choroidal area
Summary
As metabolic support for the prelaminar portion of the optic nerve head is provided by the choroid [1,2,3], this suggests that it may play an important role in glaucoma [4,5,6]. Several investigations have reported increases in the subfoveal and peripapillary choroidal thicknesses in primary open-angle glaucoma (POAG) and in primary angle closure glaucoma (PACG) after trabeculectomy-caused IOP reductions [11,12,13]. Measurements of the choroidal thicknesses in these previous studies were performed at 1.7 mm superior, temporal, inferior, and nasal to the optic disc center and at 1 and 3 mm nasal, temporal, superior, and inferior to the fovea. We recently found that the increases that occurred at 2 weeks after trabeculectomy in the macular and peripapillary choroidal areas due to increases in the luminal areas were related to the reduction in the IOP that occurred after the surgery [15]. The aim of our current study was to investigate the choroidal area changes that occurred at 1 year after the initial trabeculectomy
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